Aid1· and HIV infection in Slovenia 
Clinical study 
AIDS AND HIV 
INFECTION IN SLOVENJA 
L. Vidmar, I. Klavs, J. Tomažič, M . Matičič, M. Poljak, L. Kristančič and 
S. Levičnik-Stezinar 
ABSTRACT 
The AIDS and HIV epidemic in Slovenia is stili at its early stage. By March 1, 1995 the cumulative total 
of 39 AIDS cases were reported in Slovenia (19.5 per million population). The annual AIDS incidence rate 
in the period 1986 to 1994 varied from 0.5 to 3.5 per million population. 
Most of the male patients (36) acquired infection by sexual contact with men (56% ), followed by 
heterosexual transmission in 7 (18%) and haemophiliacs in 4 (10% ). 3 patients belong to category "other" 
(unknown) and 2 patients to intravenous drug users. 
In 54 persons with HIV infection (non AIDS) the transmission categories are very similar to that of AIDS. 
Data on reported cases of AIDS and HIV infection provide an important information on development of 
epidemic but the reliable estimation of distribution and spread of HIV infection in different population 
groups according to demographic and behavioural characteristics is not available. 
KEY WORDS 
AIDS, epidemiology, data, transmission, Slovenia 
BACKGROUND 
Epidemiological monitoring of AIDS and HIV 
infection is essential for planning, implementing and 
monitoring AIDS prevention and control activities. 
METHODS 
Ali data on AIDS and HIV infection cases are 
collected, analyzed and interpreted at the Institute 
of Public Health of the Republic of Slovenia. The 
registration is mandatory. Por the reporting of AIDS 
cases we use 1993 revision of the European AIDS 
surveillance case definition (1 ). 
acta dermatovenerologica A.P A. Vol 4, 95, No 3 
RESULTS 
We registered the first AIDS patient in June 1986 
(2). By March 1, 1995 the cumulative total of 39 
AIDS cases were reported in Slovenia (fig. 1). The 
yearly AIDS incidence rate in the period 1986 to 
1994 varied from 0.5 to 3.5 per million population 
(fig. 2). In the cumulative number of 39, there were 
36 male and 3 female cases. Over a half of cases 
(22), i.e. 56%, were aged between 25 to 39 years. 
The majority of cases come from the region of 
Ljubljana. 25 patients already died. 
Most of the male patients acquired infection by 
homosexual intercourse (56% ). Heterosexual contact 
145 
Aidf and HW infection in Slovenia 
.. 87 88 89 _ 90 91 92 93 94 95 
j • -aids deaihs (12.5 per million) • aids cases (19.5 per million) J 
Fig. l. Cumulative number or registered AIDS cases 
and AIDS deaths in Slovenia (by March 1, 1995) 
was the mode of HIV transmission in 7 cases 
(18% ), 4 male (ali being infected by heterosexual 
contact in Africa) and 3 female. 4 patients (10%) 
belong to the high risk group of haemophiliacs. 3 
patients in the category "other/unknown" most probably 
got infected by heterosexual contact, were not reporting 
the intercourse with sexual partner from one of the 
high risk behaviour groups. In 1992, the first pediatric 
AIDS case was registered in a child of less then 
one year of age. He was infected vertically from his 
mother, who practiced sexual contacts with a person 
from one of the countries with epidemiological 
pattem 2 (3) (Fig. 3). 
By March 1, 1995 there has also been a total of 
54 cases of diagnosed HIV infection registered in 
Slovenia, having no signs or symptoms of AIDS yet. 
There are 39 adult male, 12 adult female cases and 
3 children below 15 years of age. Among 39 male 
cases, the majority (20), i.e. 51 %, attributed to 
homosexual contact, followed by the haemophiliacs 
(9), i.e. 23%. Ali the infected haemophiliacs received 
blood products from the blood which had not been 
tested for HIV, that means before the era of 
legalized mandatory testing of ali donated blood in 
January 1986 ( 4). We registered only one infection 
of haemophiliac after blood transfusion done by our 
blood donor (5). Ali the heterosexually infected in 
this group practiced sexual contacts in subsahar 
Africa. 
There are 12 HIV positive cases reported among 
adult women in Slovenia. In the cumulative total 
of all registered adult AIDS cases and cases with 
HIV infection (89) there are 15 female cases (17% ). 
In the group of HIV positive cases, 8 women (67%) 
acquired the infection by heterosexual contact. 3 
women confessed using of intravenous drugs (fig. 
146 
, , 
.. 87 88 89 90 91 92 93 94 95 
Fig. 2. Yearly registered AIDS cases in Slovenia (by 
March 1, 1995) 
5). Of 89 reported infected adult cases in Slovenia 
(HIV infection and AIDS), 7 (8%) probably got 
infected by sharing infected needles. 
There are also 3 known cases of pediatric HIV 
infection without signs or symptoms of AIDS. Two 
of them are haemophiliacs in the age group 14 to 
15 years and the third is a 6 years old girl, who 
was vertically infected by her mother. 
From January 1986 till the end of 1993, 816.700 
samples of donated blood were tested. 10 blood 
donors tested for anti-HIV antibodies were positive 
(1.25 per 100.000 samples) (Table 1). 
DISCUSSION 
Incubation period of AIDS is long. The picture of 
registered AIDS cases reveals the pattem of HIV 
transmission, dating from years ago. 
Data on reported HIV cases can not reflect 
current HIV prevalence and incidence rates in 
particular population groups in certain periods of 
tirne. 
IN= 391 
Fig. 3. Cumulative number or registered AIDS cases in 
Slovenia by the risk factors (by March 1, 1995) 
acta dermatovenerologica A.P A. Vol 4, 95, No 3 
Aidl' and HW infection in Slovenia 
Tab. 1. Number of taken blood samples and number of anti-HIV-1 positive blood donors in the period 1986-1993 
in Slovenia 
L number of 
year number of sarnples number of newly taken sarnples anti-HIV-1 + 
blood donors 
ZTK* others total ZTK* others total 
1986 60413 44988 105401 5804 4490 10294 3 
1987 55740 45858 101598 4653 3669 8322 1 
1988 57108 48107 105215 5458 4570 10028 1 
1989 · 55906 48138 104044 4975 4332 9307 3 
1990 59231 49571 108802 4916 3960 8876 o 
1991 52650 45809 98459 3516 3207 6723 1 
1992 50203 43249 93452 4123 3460 7583 o 
1993 56178 43551 99729 5575 3816 9391 1 
total 447429 369271 816700 39020 31504 70524 10 
* . . . ZAVOD RS ZA TRANSFUZIJO KRVI [Blood Transfusion Centre of Slovenia] 
1.25 anti-HIV-1 + per 100,000 samples 
CONCLUSIONS 
The reliable estimation of distribution and spread 
of HIV infection in different population groups 
according to demographic and behavioural cha-
racteristics is not available. Data on reported cases 
provide an important information on development 
of epidemic. The AIDS and HIV epidemic in 
Slovenia is still at its early stage. In spite of risk 
behaviour patterns in various population groups 
practicing unprotected penetrative sexual contact 
and sharing equipment for injecting drugs, the 
explosive transmission of HIV has not been noticed 
in any of sentinel groups. Should the virus be 
brought into those groups in larger proportion, a 
spread can be expected. 
REFERENCES 
l. European Center for Epidemiological Monitoring 
of AIDS, WHO-EC Collaborating Centre on AIDS. 
1993 Revision of the European AIDS Surveillance 
in Europe. Quarterly Report No. 37, 31 March 
1993: 23-8. 
3. European Center for the Epidemiological 
Monitoring of AIDS, WHO-EC Collaborating Centre 
on AIDS. AIDS Surveillance in Europe. Quarterly 
Report No. 43, 1994: 1-33. 
2. Klavs I, Vidmar L, Glonar L. Epidemiology and 
natural histo:ry of HIV infection and AIDS. Zdrav 
Vestn 1990. 59: 125-30. 
4. Klavs l. Okužba z virusom HIV: pandemija ter 
epidemija v Sloveniji. Zdrav Var 1993; 32: 272-5. 
5. Tomažič J, Vidmar L, Matičič M et al. 1994: 
AIDS Worldwide and in Slovenia. Zdrav Vestn 
1994; 63: 745-9. 
AUTHORS' ADDRESSES 
Ludvik Vidmar, MD, Head Dpt. of infectious diseases, Clinical Centre 
Japljeva 2, 61000 Ljubljana, Slovenia 
Irena Klavs, MD, MSc, Institute of Public Health of the Republic of Slovenia, Trubarjeva 2, 
61000 Ljubljana, Slovenia 
Janez Tomažič, MD, MSc, Dpt. of infectious diseases, Clinical Centre, 
Japljeva 2, 61000 Ljubljana, Slovenia 
Mojca Matičič, MD, same address 
Mario Poljak, MD, PhD, Institute of microbiology, Korytkova 2, 61000 Ljubljana, Slovenia 
Lidija Kristančič, same address 
Snežana Levičnik Stezinar, MD, Blood Transfusion Center of Slovenia 
Šlajmerjeva 6, 61000 Ljubljana, Slovenia 
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